Aktan, Adem

Aktan, Adem

Name Variants

Aktan, A.
Aktan, Adem

Job Title

Doç. Dr.

Main Affiliation

Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü

Status

Current Staff

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Scholarly Output

32

Articles

31

Citation Count

0

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Now showing 1 - 10 of 32

Citation - WoS: 3
Citation - Scopus: 3
The prognostic value of ORBIT risk score in predicting major bleeding in patients with acute coronary syndrome
(ScienceDirect, 2023) Günlü, Serhat; Kayan, Fethullah; Kılıç, Raif; Aktan, Adem; Kılıç, Raif; Aktan, Adem; Altintaş, Bernas; Karahan, Mehmet Zülkif; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü
Background: The most significant adverse effect of antithrombotic medication in acute coronary syndrome (ACS) is major bleeding, which is related to increased mortality. Studies on ORBIT risk score in predicting major bleeding in ACS patients are limited. Objective: This research aimed to examine whether the ORBIT score calculated at the bedside can identify major bleeding risk in patients with ACS. Methods: This research was retrospective, observational, and conducted at a single center. Analyses of receiver operating characteristics (ROC) were utilized to define the diagnostic value of CRUSADE and ORBIT scores. The predictive performances of the two scores were compared using DeLong's method. Discrimination and reclassification performances were evaluated by the integrated discrimination improvement (IDI), and net reclassification improvement (NRI). Results: The study included 771 patients with ACS. The mean age was 68.7 ± 8.6 years, with 35.3 % females. 31 patients had major bleeding. Twenty-three of these patients were BARC 3 A, five were BARC 3 B, and three were BARC 3 C. Bleeding history [OR (95 % CI), 2.46 (1.02-5.94), p = 0.021], hemoglobin levels [OR (95 % CI), 0.54 (0.45-0.63), p < 0.001], and age > 74 years [OR (95 % CI), 1.03 (1.01-1.06), p = 0.039] were independent predictors of major bleeding. The ORBIT score was an independent predictor of major bleeding in the multivariate analysis: continuous variables [OR (95 % CI), 2.53 (2.61-3.95), p < 0.001] and risk categories [OR (95 % CI), 3.06 (1.69-5.52), p < 0.001]. Comparison of c-indexes for major bleeding events revealed a non-significant difference for the discriminative ability of the two tested scores (p = 0.07) with a continuous NRI of 6.6 % (p = 0.026) and an IDI of 4.2 % (p < 0.001). Conclusion: In ACS patients, the ORBIT score independently predicted major bleeding.
Citation - WoS: 1
Citation - Scopus: 1
Association Between the Triglyceride-Glucose Index and Contrast-Induced Nephropathy in Chronic Total Occlusion Patients Undergoing Percutaneous Coronary Intervention
(Bmc, 2025) Aktan, Adem; Aktan, Adem; Kilic, Raif; Guzel, Hamdullah; Tastan, Ercan; Oksul, Metin; Guzel, Tuncay; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü
Objective The triglyceride glucose (TyG) index is a biomarker of insulin resistance and is associated with an increased risk of cardiovascular events. Contrast-induced nephropathy (CIN) is an important complication that causes poor outcomes in patients undergoing percutaneous coronary intervention (PCI). In this study, we aimed to investigate the relationship between the TyG index and CIN and mortality in patients who underwent PCI due to chronic total coronary occlusion (CTO). Methods Two hundred eighteen individuals from three separate medical centers who underwent procedural PCI between February 2010 and April 2012 and had a CTO lesion in at least one coronary artery were recruited. According to the TyG index, patients were divided into two groups. Patients with a TyG index >= 8.65 were included in Group 1, and patients with a TyG index < 8.65 were included in Group 2. Patients were followed up for 96 months. The main outcome was the development of CIN and mortality. Results The mean age of the patients (65.8 +/- 10.94 vs. 61.68 +/- 11.4, P = 0.009), diabetes mellitus (60 [44.8%] vs. 11 [13.1%], P < 0.001), and dyslipidemia rates (52 [38.8%] vs. 21 [25%], P = 0.036) were higher in group 1. In multivariable logistic regression analysis, it was seen that age (OR = 1.04, 95% CI = 1.01-1.08, P = 0.020), chronic kidney disease (OR = 2.34, 95% CI = 1.02-5.33, P = 0.044), peripheral artery disease (OR = 5.66, 95% CI = 1.24-25.91, p = 0.026), LVEF (OR = 0.95, 95% CI = 0.92-0.99, P = 0.005), LDL cholesterol levels (OR = 1.00, 95%CI = 1.00-1.02, P = 0.024) and TyG index (OR = 2.17, 95% CI = 1.21-3.89, P = 0.009) were independent predictors of the development of CIN. Conclusion Our study demonstrates a correlation between the TyG index and the prevalence of CIN in patients with CTO undergoing PCI. Adding the TyG index to the routine clinical evaluation of patients with CTO undergoing PCI may help protect patients from the development of CIN.
Citation - WoS: 0
Citation - Scopus: 0
A Novel Determinant of Prognosis in Acute Pulmonary Edema: Intermountain Risk Score
(Kare Publ, 2024) Aktan, Adem; Aktan, Adem; Guzel, Tuncay; Kaya, Ahmet Ferhat; Guzel, Hamdullah; Arslan, Bayram; Cankaya, Yusuf; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü
Objective: The Intermountain Risk Score (IMRS), calculated using age, gender, complete blood count (CBC), and simple laboratory analyses, is an easy-to-use and cost-effective tool developed to predict mortality. In our study, we aimed to determine whether the IMRS could predict mortality in patients admitted to the hospital with a diagnosis of acute pulmonary edema. Methods: A total of 371 patients who were admitted with a diagnosis of pulmonary edema, were included in our study. The IMRS of the patients was determined using a calculation tool, and the patients were divided into three groups based on the determined value: low, moderate, and high IMRS. Results: The patients included in our study comprised 208 women and 163 men, with an average age of 68.7 years. There was a statistically significant difference between the patient groups concerning both 1-month and 1-year mortality rates. Additionally, there was a significant difference in IMRS between patients who developed in-hospital, 1-month, and 1-year mortality and those who survived. In the Receiver Operating Characteristic (ROC) analysis, a cutoff value of 15.5 for the IMRS predicted both 1-year and 1-month mortality. In the Kaplan-Meier analysis, the highest mortality risk was observed in the high IMRS group and the lowest mortality risk in the low IMRS group. Conclusion: Our research results show that the IMRS strongly predicts both short-term and long-term mortality in patients hospitalized with a diagnosis of acute pulmonary edema.
Citation - Scopus: 5
The effect of coronary slow flow on ventricular repolarization parameters
(ScienceDirect, 2023) Karahan, Mehmet Zülkif; Aktan, Adem; Günlü, Serhat; Kılıç, Raif; Kılıç, Raif; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü
Introduction: Ischemia due to microvascular dysfunction may be responsible for the heterogeneity of ventricular repolarization in coronary slow flow. To our knowledge, there is no study in which QT interval, Tp-Te interval, index of cardiac-electrophysiological balance (iCEB), and frontal QRS-T angle were evaluated together in patients with CSF. In this study, we examined for the first time the relationship between all these myocardial repolarization parameters and CSF. Materials and methods: The study group included 178 patients (99 female, mean age: 50.6 ± 8.6 years) with isolated CSF without stenotic lesions and with angiographically proven normal coronary arteries. The control group included 120 patients (71 female, mean age: 49.3 ± 9.4 years) with normal coronary angiography. QRS duration, QT interval, QTc interval, Tp-Te interval, Tp-Te/QT, Tp- Te/QTc, iCEB score, and frontal QRS-T angle were calculated from 12‑lead ECGs. Results: There was no significant difference in demographic parameters between the two groups. Compared with the control group, patients with CSF had significantly longer QTmax duration, QT dispersion, Tp-Te interval, and higher iCEB score, wider frontal QRS-T angle. Conclusion: In our study, we found that many of the ventricular repolarization parameters were adversely affected in patients with CSF. Impaired parameters may be associated with the risk of malignant ventricular arrhythmias.
Citation - WoS: 7
Citation - Scopus: 7
Comparison of Pain Levels of Traditional Radial, Distal Radial, and Transfemoral Coronary Catheterization
(Assoc Medica Brasileira, 2023) Günlü, Serhat; Kılıç, Raif; Kilic, Raif; Guzel, Tuncay; Aktan, Adem; Aktan, Adem; Arslan, Bayram; Karahan, Mehmet Zülkif; Aslan, Muzaffer; Gunlu, Serhat; Karahan, Mehmet Zulkuf; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü
OBJECTIVE: The aim of our study was to compare the traditional radial artery, distal radial artery, and transfemoral artery, which are vascular access sites for coronary angiography, in terms of pain level using the visual analog scale.METHODS: Between April 2021 and May 2022, consecutive patients from three centers were included in our study. A total of 540 patients, 180 from each of the traditional radial artery, distal radial artery , and transfemoral artery groups, were included. The visual analog scale was applied to the patients as soon as they were taken to bed. RESULTS: When the visual analog scale was compared between the groups, it was found to be significantly different (transfemoral artery: 2.7 & PLUSMN;1.6, traditional radial artery: 3.9 & PLUSMN;1.9, and distal radial artery: 4.9 & PLUSMN;2.1, respectively, p<0.001). When the patients were classified as mild, moderate, and severe based on the visual analog scale score, a significant difference was found between the groups in terms of body mass index, process time, access time, and number of punctures (p<0.001). Based on the receiver operating characteristic analysis, body mass index>29.8 kg/m2 predicted severe pain with 72.5% sensitivity and 73.2% specificity [(area under the curve: 0.770, 95%CI: 0.724-0.815, p<0.0001)].CONCLUSION: In our study, we found that the femoral approach caused less access site pain and a high body mass index predicts severe pain.
Citation - WoS: 1
Citation - Scopus: 1
The Effectiveness of Halp Score in Predicting Mortality in Non-St Myocardial Infarction Patients
(Lippincott Williams & Wilkins, 2025) Aktan, Adem; Guzel, Tuncay; Aktan, Adem; Guzel, Hamdullah; Kaya, Ahmet Ferhat; Cankaya, Yusuf; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü
Background:The HALP score, measured based on hemoglobin, albumin, lymphocyte, and platelet levels, is regarded as a novel scoring system that indicates the status of systemic inflammation and nutritional health. Our study aimed to evaluate the relationship between HALP score and prognosis in non-ST-elevation myocardial infarction (NSTEMI) patients. Methods Between 1 January 2020 and 1 January 2022, 568 consecutive patients diagnosed with NSTEMI from a single center were included in the study retrospectively. The patients were divided into two equal groups according to the median HALP cutoff value of 44.05. Patients were followed for at least 1 year from the date of admission. Results The average age of the patients was 62.3 +/- 10.6 years and 43.7% were female. In-hospital and 1-year mortality were found to be significantly higher in the group with low HALP scores (6.0 vs. 2.1%, P = 0.019 and 22.5 vs. 9.9%, P < 0.001, respectively). In receiver operating characteristic curve analysis, a cutoff level of 34.6 of the HALP score predicted 1-year mortality with 71% sensitivity and 65% specificity (area under the curve: 0.707, 95% confidence interval: 0.651-0.762, P < 0.001). In Kaplan-Meier analysis, higher mortality rates were observed over time in the group with lower HALP scores (log-rank test=16.767, P < 0.001). In Cox regression analysis, the HALP score was found to be an independent predictor of 1-year mortality (odds ratio: 0.969, 95% confidence interval: 0.958-0.981, P < 0.001). Conclusion We found that a low HALP score could predict in-hospital and 1-year mortality in patients admitted to the hospital with a diagnosis of NSTEMI.
KRONİK HASTALIĞI OLAN BİREY VE AİLE İLE İLETİŞİM
(2023) Aktan, Adem; Karahan, Mehmet Zülkif; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü
Kronik hastalık, uzun süreli tedavi gerektiren ve hayatı boyunca sürebilecek bir sağlık durumunu ifade eder. Bunlar, diyabet, hipertansiyon, kalp hastalığı, kanser, multipl skleroz gibi bir dizi farklı hastalığı içerebilir. Kronik hastalık tanısı alan bireylerin ve ailelerin yaşamlarında büyük bir etkiye sahip olabilir ve duygusal, sosyal ve fiziksel zorluklara neden olabilir. Bu nedenle, kronik hastalık tanısı almış bireylerle ve aileleriyle iletişim kurarken dikkatli ve duyarlı olmak önemlidir (1). İletişim, bireylerin duygularını ifade etmelerine, endişelerini paylaşmalarına ve birbirleriyle destek sağlamalarına yardımcı olabilir. Kronik hastalıkla ilgili iletişim becerileri, bireylerin sağlıklı bir şekilde başa çıkmalarına ve daha iyi sonuçlar elde etmelerine yardımcı olabilir. Kronik hastalık tanısı almış bireyler ve aileleri arasındaki iletişim, aşağıdaki bazı temel prensiplere dikkat ederek etkili bir şekilde gerçekleştirilebilir: Açık iletişim kurma: Kronik hastalık tanısı almış bir bireyin ve ailesinin duygularını ve deneyimlerini anlamak için empati kurmak önemlidir. Açık iletişim, dürüst, saygılı ve etkili bir iletişim tarzını içerir. Kronik hastalık tanısı almış bir birey ve ailesiyle iletişim kurarken açık ve net olmak önemlidir. VII. Sonuç Kronik hastalık tanısı almış bireyler ve aileleriyle etkili iletişim kurmak önemlidir. Etkili iletişim, hastaların sağlık sonuçlarını, yaşam kalitesini ve memnuniyetini artırabilir. Ailelerin de katılımıyla birlikte, uygun tıbbi bakım sağlanabilir ve sağlıklı bir iyileşme süreci desteklenebilir. Bu nedenle, sağlık profesyonellerive diğer ilgili paydaşlar, hastalarla etkili iletişim kurma becerilerini geliştirmek için yönlendirilmelidir. Kronik hastalık yönetiminde etkili iletişim, hastaların ve ailelerinin gereksinimlerini anlamak ve onları desteklemek için vazgeçilmez bir araçtır.
Citation - WoS: 1
Citation - Scopus: 1
The effect of body mass index on complications in cardiac implantable electronic device surgery
(WILEY, 2023) Günlü, Serhat; Aktan, Adem; Kılıç, Raif; Kılıç, Raif; Arslan, Bayram; Günlü, Serhat; Altıntaş, Bernas; Karahan, Mehmet Zülkif; Özbek, Mehmet; Aslan, Burhan; Arpa, Abdulkadir; Coşkun, Mehmet Sait; Altunbaş, Mahsum; Tüzün, Rohat; Akgümüş, Alkame; Karadeniz, Muhammed; Aydın, Saadet; Güzel, Hamdullah; Aslan, Selen Filiz; Söner, Serdar; Taş, Ahmet; Ertaş, Faruk; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü
Background: Cardiac implantable electronic device (CIED) procedures are prone to complications. In our study, we investigated the effect of body mass index (BMI) on CIED-related complications. Methods: 1676 patients who had undergone CIED surgery (de novo implantation, system upgrade, generator change, pocket revision or lead replacement) at two heart centers in Turkey and met the study criteria were included in our study. For analysis of primary and secondary endpoints, patients were classified as non-obese (BMI < 25 kg/m2), overweight (25 ≤ BMI < 30 kg/m2), and obese (BMI ≥ 30 kg/m2). The primary endpoint was accepted as cumulative events, including the composite ofclinically significant hematoma (CSH), pericardial effusion or tamponade, pneumoth- orax, and infection related to the device system. Secondary outcomes included each component of cumulative events. Results: The rate of cumulative events, defined as primary outcome, was higher in the obese patient group, and we found a significant difference between the groups (3.0%, 4.3%, 8.9%, p = .001). CSH and pneumothorax rates were significantly higher in the obese patient group (0.3%, 0.9%, 1.9%, p = .04; 1.0%, 1.4%, 3.3%, p = .04, respectively). According to our multivariate model analysis; gender (OR:1.882, 95%CI:1.156–3.064, p = .01), hypertension (OR:4.768, 95%CI:2.470–9.204, p < .001), BMI (OR:1.069, 95%CI:1.012–1.129, p = .01) were independent predictors of cumulative events rates. Conclusions: Periprocedural complications associated with CIED (especially hematoma and pneumothorax) are more common in the group with high BMI.
Citation - WoS: 2
Aging and cardiac implantable electronic device complications: is the procedure safe in older patients?
(ELSEVIER, 2023) Günlü, Serhat; Aktan, Adem; Kılıç, Raif; Günlü, Serhat; Arslan, Bayram; Arpa, Abdulkadir; Güzel, Hamdullah; Tatlı, İsmail; Aydın, Saadet; Suzan, Veysel; Demir, Muhammed; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü
Background In this study, we investigated whether there is a higher incidence of cardiac implantable electronic devices (CIED) procedures related complications in older (≥75 years) than in younger (<75 years) patients. Methods This retrospective cohort study enrolled patients who had undergone CIED procedures (de novo implantation, system upgrade, generator substitution, pocket revision or lead replacement) at two heart centers in Turkey between January 2011 and May 2023. The primary composite endpoint included clinically signifcant hematoma (CSH), pericardial efusion or tamponade, pneumothorax, and infection related to the device system. Secondary outcomes included each component of the composite end point. Results The overall sample included 1923 patients (1419<75 years and 504 aged≥75 years). There was no diference between the groups in terms of cumulative events defned as primary outcome (3.5% vs. 4.4%, p=0.393). Infection related to device system was signifcantly higher in the≥75 age group (1.8% vs. 3.4%, p=0.034). There was no signifcant diference between the groups in terms of clinically signifcant hematoma and pneumothorax (0.7% vs. 0.4%, p=0.451, 1.4% vs. 1.0%, p=0.477, respectively). In multivariate model analysis, no association was found between age≥75 years and infection related to the device system. Conclusion Infection rates were relatively higher in the patient group aged≥75 years. This patient group should be evaluated more carefully in terms of infection development before and after the procedure.
Citation - WoS: 2
Citation - Scopus: 2
Aging and cardiac implantable electronic device complications: is the procedure safe in older patients?
(Springer, 2023) Günlü, Serhat; Aktan, Adem; Kılıç, Raif; Günlü, Serhat; Arslan, Bayram; Arpa, Abdulkadir; Güzel, Hamdullah; Tatlı, İsmail; Aydın, Saadet; Suzan, Veysel; Demir, Muhammed; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü
Background: In this study, we investigated whether there is a higher incidence of cardiac implantable electronic devices (CIED) procedures related complications in older (≥ 75 years) than in younger (< 75 years) patients. Methods: This retrospective cohort study enrolled patients who had undergone CIED procedures (de novo implantation, system upgrade, generator substitution, pocket revision or lead replacement) at two heart centers in Turkey between January 2011 and May 2023. The primary composite endpoint included clinically significant hematoma (CSH), pericardial effusion or tamponade, pneumothorax, and infection related to the device system. Secondary outcomes included each component of the composite end point. Results: The overall sample included 1923 patients (1419 < 75 years and 504 aged ≥ 75 years). There was no difference between the groups in terms of cumulative events defined as primary outcome (3.5% vs. 4.4%, p = 0.393). Infection related to device system was significantly higher in the ≥ 75 age group (1.8% vs. 3.4%, p = 0.034). There was no significant difference between the groups in terms of clinically significant hematoma and pneumothorax (0.7% vs. 0.4%, p = 0.451, 1.4% vs. 1.0%, p = 0.477, respectively). In multivariate model analysis, no association was found between age ≥ 75 years and infection related to the device system. Conclusion: Infection rates were relatively higher in the patient group aged ≥ 75 years. This patient group should be evaluated more carefully in terms of infection development before and after the procedure.